Provider Demographics
NPI:1033315999
Name:DYSICO, GERARD L (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:L
Last Name:DYSICO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:15900 SOUTH CICERO AVENUE
Mailing Address - Street 2:DEPARTMENT OF REHABILITATION SERVICES
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4006
Mailing Address - Country:US
Mailing Address - Phone:708-633-3091
Mailing Address - Fax:708-633-2006
Practice Address - Street 1:15900 SOUTH CICERO AVENUE
Practice Address - Street 2:DEPARTMENT OF REHABILITATION SERVICES
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4006
Practice Address - Country:US
Practice Address - Phone:708-633-3091
Practice Address - Fax:708-633-2006
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2021-04-23
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Provider Licenses
StateLicense IDTaxonomies
IL036.117792208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation